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As a new nurse, just into my 3rd month, I find myself annoying my co-workers, doctors, patients, and MYSELF, by either doing or NOT doing things that I should. I know I'm new and I have to learn, but I hate the looks and attitudes of annoyance I get from others when I screw up.
One example of my many missteps- I had a patient today who had a foley placed last night. It was draining brick red urine and the MD was aware. About 5:30 he started moaning and yelling about pain, but whenever I would ask where the pain was, he would just say "everywhere!!" He has a hx of osteoarthritis and was in the hosp for that. Meanwhile, he had bloody urine leaking out from around the foley, saturating his gown (3 changes!) I told the MD and he just said "I know" and carried on.
I thought maybe it was constipation because he had not pooped in a while, so I gave him an enema, and it relieved him for a while, but come 9 he's screaming and yelling again. I tried pain meds, but it wasn't touching it. More bloody urine on the gowns. I call the hospitalist and she says "not my problem, call urology" I call urology and he yells at me for waiting until 9:45 to call him and what can he do. He sends the surgeon who put the foley in.
Here's the part that kills me. My charge nurse comes in while I'm waiting for the surgeon, and looks at the cath. She takes a syringe, flushes it, and whoosh, out comes all this urine!! Patient is relieved, surgeon isn't needed (though he shows up anyways, though at least he was nice about it!!) and I'm left looking like an ass because it was something so simple that I didn't even think to do.
I thank my charge nurse and say that I wish I could absorb knowledge. She gets a bit snotty with me and tells me that I should use all my factualities to figure things out and that I need to watch what I say to doctors. That it wasn't "bloody", it was serosanguineous.
In a passive aggressive way, she is always alluding to the fact that I'm a moron who doesn't think things through. The thing is, being a new nurse, I don't KNOW what to do in many cases, and I hate always asking because people get annoyed (no matter what they say)
My main point or question here is -Does anyone know of a website or an app that you can type in a question and find a solution to it?? Like "foley not draining" "IV occluding", etc? Agh, I hate this feeling of useless stupidness!! I forget about 10 things a night, and the night shift always complains and questions why I didn't do things, or I did them the wrong way. BLAH.
Sorry for the long post!! Thanks in advance! :-/
Why didn't the ignorant people you work with ask you if you tried repositioning or flushing the catheter? Was there an order to flush prn, or change if needed? Usually that is a standing order. You will learn from this and many more, just would be nice if you worked around some civilized people! When they do not assist or help you, as you are new, they are in a sense neglecting a patients care.
Anyway, I always tell the senior nurse/shift coordinator if anything is wrong with a patient. Tell them before the doctor & let them handle it - that is their job in most cases. They shouldn't really mind, as they do have more experience.
It is very annoying to me as a charge nurse when a newer nurse calls a doc over something without running the situation by me. I'm not talking about for extra pain meds...I'm talking about for unusual situation, etc. A large amount of the time there are things we can try or areas we need to assess before we call the doc. I try not to be grumpy when someone asks me something I think they should know...but I do get grumpy when some one calls for something we have a protocol for, or for something we nurses should know or be able to deal with.
It's also about team work. If I have a question or an iffy situation, I often run it by my fellow coworkers. I don't operate in a vacuum, newer nurses definitely shouldn't.
I am a new nurse to and can feel your pain. I recently resigned from my first job (ER), and will be starting med-surg next week. I am not sure if it was the hospital system, this one hospital, the ER environment or me, but I was not happy. I didn't feel backed up, and I felt stupid most of the time. If I asked a question of my preceptor she would often ream me for asking then run to the educator to tell her that I didn't know this or that. If I didn't ask then I was reamed for not asking questions. If I asked another nurse, and my preceptor found out about it I was reamed for not going to her. Some of the other nurses found my situation entertaining which made it even worse. Others tried to encourage me to stick it out, patted me on the shoulder with words of encouragement and told me they were sorry I was stuck with this preceptor. I went to the educator and asked to have my preceptor switched, but I was told that she was a good nurse, and I should listen to her. I never imagined it would be this way. I envisoned that everyone would see how excited, and eager I was and want to help me to become the best nurse I could be ..LOL. As a new nurse this is my first exposure to some of these things. There are literally things that I don't know I don't know yet. Expecting me to know everything straight out of school, and before my internship was completed was unreasonable. I noticed that there were things that my seasoned nurse had to go to other nurses for help with, but she didn't ream herself for not knowing. I don't have the answer, but I do hope my next experience is better. My confidence has been smashed.
I have seen two little old cachexic ladies in the nursing homes develop massive growths on their lower abdomens-both were about the size and shape of footballs. Guess how many nurses had NO idea what they were looking at? Both lpn's and rn's- several with many years of experience. Like they say "when you hear hoofbeats, think horses,not zebras" The growths were their FULL bladders. Everyone was spinning their wheels-could it be a tumor? Is she bleeding internally? etc etc....The first gal went to the er. I'm sure they still laugh over that case. Luckily 2 of us involved in the first case were present when the second occurred so we called the doc and got an order to cath... Good Luck-we don't all treat co-workers like fools and hopefully when you are the experienced nurse on the unit you won't either.
Maybe we should all suggest that teaching and mentoring should be added to the curriculum in nursing school. Unfortunately, sometimes the kids of abusers become abusers themselves, and its known that those who are oppressed or intimidated often wind oppressing and intimating others. That older nurse you asked was wrong. She should have helped you. But hospitals aren't great places many time for treating each others with respect. Doctors often intimidate nurses, and so if a nurses is overwhelmed and has been fighting for a long time and has a heavy work load, she forgets who she started out being. Nurses would have so much more power if we all hung together as a team. Then nothing could beat us. Keep asking questions, and then when your patients ask you questions, you'll remember how you felt when you didn't know and you'll be kind to them. :)
I am a new nurse to and can feel your pain. I recently resigned from my first job (ER), and will be starting med-surg next week. I am not sure if it was the hospital system, this one hospital, the ER environment or me, but I was not happy. I didn't feel backed up, and I felt stupid most of the time. If I asked a question of my preceptor she would often ream me for asking then run to the educator to tell her that I didn't know this or that. If I didn't ask then I was reamed for not asking questions. If I asked another nurse, and my preceptor found out about it I was reamed for not going to her. Some of the other nurses found my situation entertaining which made it even worse. Others tried to encourage me to stick it out, patted me on the shoulder with words of encouragement and told me they were sorry I was stuck with this preceptor. I went to the educator and asked to have my preceptor switched, but I was told that she was a good nurse, and I should listen to her. I never imagined it would be this way. I envisoned that everyone would see how excited, and eager I was and want to help me to become the best nurse I could be ..LOL. As a new nurse this is my first exposure to some of these things. There are literally things that I don't know I don't know yet. Expecting me to know everything straight out of school, and before my internship was completed was unreasonable. I noticed that there were things that my seasoned nurse had to go to other nurses for help with, but she didn't ream herself for not knowing. I don't have the answer, but I do hope my next experience is better. My confidence has been smashed.
Sorry to hear that this happened to you. When you get some Med/Surg experience under your belt try the ER again. I don't feel the ER is a good place for inexperienced nurses, they tend to have many nurses with "strong personalities" that are not necessarily happy to teach.:redbeathe
I have a really great charge nurse, who says she would much rather have a new nurse ask a question, than do something without asking that causes a problem. She is right. I have about 8 months in and have learned alot. Try not to get upset when something simple fixes a problem and you feel stupid. That simple solution is one that you will never forget, and it is worth feeling bad for a short time to have something stamped in your brain forever.
I think being a little older as a new grad has helped me. I ask questions, millions of them every day. I really don't give a crap if it annoys someone. My job is to take care of my patients and to learn as much as I can as fast as I can. When something like this happens, I treat it as a learning experience. I ask the experienced nurse what I missed. What made her decide to flush the foley? Would she have tried anything else first? What if that didn't work, what would she have done next? When would she have called the doctor?
If they seem annoyed I ignore it. At first I didn't want to ask some coworkers because they seemed annoyed. But I can't risk a patient's safety because someone doesn't want to teach. Thankfully most of my coworkers are happy to help and teach when they see that I am serious about learning and pick things up quickly. The culture at my work is such that we each consult with each other when we are not sure. When a patient stroked out recently my coworker with 17+ years experience asked me, of 4 months, to come assess her as well.
Add this to your learning experience, if this happens again you will know what to do. Try to find a nurse on your floor that you feel comfortable with and can bounce things off of when problems like this arise.
Sorry to say but you will never know everything. Even after all my years of nursing I still run things past my coworkers at times. I still learn new things. I think that it is okay if you don't always have all the answers. You just need to be willing to admit you don't know and be willing to learn.
Redhead28
200 Posts
I firmly believe that you will never know everything. I answer all questions that the new nurses ask of me and I try to help them reason things out so they get the answer for themselves. I have 14 years of bedside nursing behind me and I still ask questions. "The only stupid question is the one not asked"